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Morning Fix: Six Senators To Watch On Health Care

For all of the attention President Obama's Monday speech to the American Medical Association received, the true battle ground over whether or not significant health-care reform will become law this year is in the Senate.

Knowing this, the president and his inner circle have been working the issue for months -- seeking to identify strong, and, more important, weak spots among senators as well as testing out what sort of compromises are possible.

Passage of a bill so fraught with so many sorts of political peril for so many senators is a gargantuan undertaking that requires a keen understanding not just of where each member of the world's greatest deliberative body stands on the issue but also who they stand with and who they listen to.

The Fix spoke with a variety of close observers of the Senate, seeking guidance on the linchpins to keep an eye on in the coming debate. From those conversations we derived a list of six of the most important pieces to any bipartisan health-care bill.

• Utah's Republicans: Sens. Bob Bennett and Orrin Hatch may hail from one of the most Republican states in the country but both men are seen by Democrats as critical to their efforts to sell the bill. Bennett has co-sponsored health-care legislation with Oregon Sen. Ron Wyden (D) that has drawn considerable bipartisan support while Hatch is close personally to Sen. Ted Kennedy who, ailing with a brain tumor, has his best chance ever to see his dream of universal health care achieved. Bennett's support is complicated by political reality -- he is facing a serious fight for the Republican nomination from his ideological right in 2010. Playing a key role in some sort of health care compromise would not sit well with GOP activists in the Beehive State.

• Olympia Snowe: The Maine Republican sits on the Finance Committee and will likely be under considerable pressure -- given Maine's Democratic leanings -- to support some sort of compromise bill. Snowe was the only one of the ten Republicans on the Finance committee who chose not to sign a letter to the president opposing the so-called "public option"; Senate Republicans badly want a united front in opposition to the public option and Snowe holds the key.

• Bob Menendez: Mendendez, more so than any other Democratic senator, has one eye on the policy of the legislation and one eye on the political implications. If the possibility of raising taxes is floated -- Obama has said the plan can't grow the deficit and there are only so many available funding sources -- Menendez is likely to raise concerns about what voting for a tax increase could mean for targeted Democratic senators and aspiring Democratic candidates. How loud does he make his case and will it change any minds?

• Mitch McConnell: Can the Senate minority leader hold his conference in line? McConnell was unable to keep Snowe as well as Sens. Susan Collins (R-Maine) and Arlen Specter (then R-Pa.) from supporting the economic stimulus package, defections that gave Democrats the magic 60 votes. With Specter having switched parties in the interim, McConnell has even less wiggle room if he wants to block the bill. The question before the Kentucky Republican is whether he can convince senators who are up for reelection in 2010 in targeted races to oppose a bill and, if so, what will the message be for that opposition be? Simply saying no is not an option.

• Ted Kennedy: The Massachusetts senator is not likely to play a major role in the coming debate due to his illness but his presence looms over the chamber and could have real influence with wavering members. Kennedy has made it his life's work to pass universal health care and brought low by a brain tumor may not get another chance to see that vision realized. Given all of that, the symbolic import of passing some sort of legislation is considerable -- particularly on Democrats who might otherwise be inclined to take a pass.

Tuesday Fix Picks: After a long weekend and two 5+ hour plane flights, the Fix has lots of recommendations.

Steelman Still Pondering: Former Missouri state treasurer and 2008 gubernatorial candidate Sarah Steelman is still considering a run for the Show Me State's open Senate seat, she confirmed in an e-mail exchange with the Fix Monday night. "I have not ruled out a run for U.S. Senate," Steelman wrote, pushing back against an article in The Hill newspaper that suggested she was all but out and considering a run for the seat being vacated by Rep. Roy Blunt (R) who is running for the Senate. Steelman, however, has yet to file official paperwork with the Federal Election Commission to form an exploratory committee; she said that she postponed the exploratory while waiting to see what Thomas Schweich, a law professor at Washington University, would do. Schweich dropped from the race and endorsed Blunt last week. If Republicans are able to clear the primary for Blunt, it would significantly strengthen their chances at holding the seat although Secretary of State Robin Carnahan (D) still has to be considered the favorite.

Meek Clears Field: Florida Rep. Kendrick Meek received the endorsements of Reps. Debbie Wasserman Schultz and Ron Klein on Monday. Wasserman Schultz is an emerging power in the House while Klein was seen as a potential candidate himself for the opening caused by Sen. Mel Martinez's (R) retirement. The twin endorsements -- coupled with state Sen. Dan Gelber's decision to step aside recently and run for attorney general -- means that Meek is almost certainly the Democratic nominee. Whether that nomination is worth much, given the candidacy (and wide poll leads) of Gov. Charlie Crist (R) is another question.

Obama for Deeds: In an e-mail appeal aimed at recruiting volunteers for Creigh Deeds' candidacy for governor in Virginia, President Obama praises the Democratic state senator's "ability to bring people together, build consensus and deliver results." The e-mail, which was sent to the Organizing for America list, demonstrates the importance national Democrats are attaching to holding the Commonwealth governorship this year. Obama and his political inner circle have been reluctant to use the president as aggressively as many House and Senate strategists would like; will that change in gubernatorial contests in Virginia and New Jersey this fall?

The issue that needs to be front and center in this debate about national health care, which both politicians and the majority of the news media is not mentioning, is getting the for profit insurance, pharmaceutical and hospitals out of any national program intirely.

Too many of our elected officials are beholden to those very profitable industries for campaign contributions because we Americans have not demanded the campaign reform that would eliminate the grasp that lobbyist have on Washington. Our media, because of the advertising dollars these industries bring to them, are not going to speak out against those 3 groups tying up the cost to our medical care either.

Every independent study not only shows that single payer health coverage is the most COST effective, it also gives countries with it better health care. The USA ranks 37 among all industrialized countries for the health care it can deliver, under the present system of for profit health care coverage and we pay MORE than those 37th other countries!This should make every man and woman in America not only ashamed but determined to see that we receive the coverage that will bring us the better health care that these countries who have single payer systems are enjoying.

If England, coming out of the debree of bombing and the cost of a world war could start a single payer health care system, it makes the USA look pretty wimpy that we cannot do so now. And I am sick to death (pardon the pun) of the cartoons and defamers of this single payer plan. It is very obvious that not only are these people totally misinformed on the health care delivered under the single payer system in countries that have it, but also that they are probably subsidized in some way by those very for profit industries a single payer system would leave in the dust.

Canada named the creator of their single payer health care system their Number ONE National Hero. So much for the slander we hear about their health care system! And if you should ask, as I have, the citizens and doctors of those countries that have a single payer system what they think of their health care program, they would say what Canadians say-'our system is great and we would not stand to do without it.' Because they have it in those countries, business don't have to worry about providing it, making them truly competitive in the world market-which the USA now is not; the loss of US jobs is a reflection the expense of for profit insurance for businesses to provide employees-not just the economy in general.

As usual the R party has no solution except give the elite more tax cuts and they know there is no trickle down. They could care less about insurance reform because anything positive will take away profits from the same people who give millions to their party. They are out of power and not likely to get back for years so move on and let them cry.

IT IS UTTERLY SHAMEFULL AND CONTEMPTOUS THAT THIS GENTLEMAN CONSIDERS HIMSELF TO BE A SOCALLED JOURNALIST WHEN HE CONSTANTLY EVEN ABOUT TWO [2] HOURS AGO TODAY WEDNESDAY JUNE 17.2009 GOES ON TO THE BARACK OBAMA?S MAIN AND OR NUMBER ONE CABLE NETWORK CHANELL IN NEW YORK CITY MSNBC TO PROMOTE HIS LIE-BERAL DOCTRINES WITH THE REPORTERS OF TORTURE TALKING POINTS ON THIS SAME MSNBC CHANNELL OF DISGRACE TODAY HE MADE THE FARCIFICAL ARGUEMENTS THAT PRESIDENT BUSH IS NO LONGER THERE FOR THE LIE-BERALS DEMOCRATIC MONEY MACHINES TO GARNER LARGE SUMS OF MONEY . TOTALLY FALSEHOOD . AS THE DEMOCRATIC PARTY FOR YEARS NOW HAS BEEN THE PARTY OF THE MONEY WITH THE RICH WEALTHY LIE-BERALS ROBBER BARONS ON WALL STREET AND ELSEWHERE GIVING THE PARTY HUGE AMOUNTS OF THE BLOOD CRIMINAL MONEY . BARACK OBAMA THE MESSIAH IS ONE EXAMPLE AS TO THE SEVEN HUNDRED FORTY NINE MILLION DOLLARS THAT HE GOT FROM THE SAME FINANCIAL INSTITUTIONS ON WALL STREET TO BUY THE OFFICE OF THE PRESIDENCY OF THE UNITED STATES OF AMERICA THE DEMOCRATIC PARTY FOR A VERY LONG PERIOD IS THE PARTY OF THE FAT CATS ,. WELL DOCUMENTED . . I WILL REMIND THIS MAN THAT KNOWLEDGE IS POWER AND THE SHARING OF KNOWLEDGE TRUTHFULLY IS EMPOWERMENT . TO QUOTE UNQUOTE ,.HE AND NONE OF THE REPORTERS ON THE BARACK OBAMA?S CABLE STATION MSNBC SET FOURTH ANY KNOWLEDGE THAT WHICH IS TRUTHFULL . MORE TO COME TREVOR MERCHANT BRONX NEW YORK CITY WEDNESDAY JUNE 17.2009

>>Scaremongers emphasize the waits for specialists in Canada, and there’s some truth to the stories.

And really there's even more ignorance and stupidity about it than really scaremongering. I mean I've had a six month wait to see a neurologist in the US because he was the only one that I could get a referral to from my insurance company. It's not like they're denying people emergency treatment.

Long waits for specialists and elective surgery shouldn't really be anything new to anyone that's actually gone through it. Especially as a new patient.

OT: Woke up this morning, took a hit of coffee, picked up my new large economy sized Kindle and punched in to the The Fix. $1.99/month to subscribe. It jumped right to the newest entry, automatically updated. WOW. Alas no comments in the kindle edition, but it's not a great medium to type on, nothing longer than a URL is manageable.

A stunningly cool device. My partner has an Archos 7, with room 320GB of movies, I have my Kindle DX with room for 3500 books. And newpapers, and blogs, and magazines ... all automatically up to date. Vot hath Gawt wrought!

"Diane Tucker, 59, is an American lawyer who moved to Vancouver, Canada, in 2006. Like everyone else there, she now pays the equivalent of just $49 a month for health care.

Then one day two years ago, Ms. Tucker was working on her office computer when she noticed that she was having trouble typing with her right hand.

“I realized my hand was numb, so I tried to stand up to shake it out,” she remembered. “But I had trouble standing.”

A colleague called 911, and an ambulance rushed her to the nearest hospital.

“An emergency room doctor met me at the door, and they took me straight upstairs to the CT scan,” she recalled. A neurologist explained that she had suffered a stroke.

Ms. Tucker spent a week at the hospital. “The doctors were great, although there were also a couple of jerks,” she said. “The nursing staff was wonderful.”

Still, there were two patients to a room, and conditions weren’t as opulent as at some American hospitals. “The food was horrible,” she said.

Then again, the price was right. “They never spoke to me about money,” she said. “Not when I checked in, and not when I left.”

Scaremongers emphasize the waits for specialists in Canada, and there’s some truth to the stories. After the stroke, Ms. Tucker needed to make a routine appointment with a neurologist and an ophthalmologist to see if she should drive again. Initially, those appointments would have meant a two- or three-month wait, although in the end she managed to arrange them more quickly.

Ms. Tucker underwent three months of rehabilitation, including physical therapy several times a week. Again there was no charge, no co-payment.

Then, last year, Ms. Tucker fainted while on a visit to San Francisco, and an ambulance rushed her to the nearest hospital. But this was in the United States, so the person meeting her at the emergency room door wasn’t a doctor.

“The first person I saw was a lady with a computer,” she said, “asking me how I intended to pay the bill.” Ms. Tucker did, in fact, have insurance, but she was told she would have to pay herself and seek reimbursement.

Nothing was seriously wrong, and the hospital discharged her after five hours. The bill came to $8,789.29.

The pandemic is a side-issue in this discussion. The designation is based not on the virulence of H1N1 but its communicability.

But we do have a real health care emergency, it's economic, not epidemiological. Our health care is based on presumptions about the operation of capitalist markets that are essentially false; private sector ("privit secter" in Palinspeak) operations are intrinsically less efficient and effective than government-operated ones, and the competition that is heralded as the engine of efficiency is really just wasteful duplication of effort.

After WWII there was a "baby boom," an explosion of births, and that generation is now beginning to retire. The system is underfunded, and the glorious free market has managed to leave 50 million with no health care but the emergency room, hands down the most expensive care there is.

It’s official. America and the World are now in a GLOBAL PANDEMIC. A World EPIDEMIC with potential catastrophic consequences for ALL of the American people. The first PANDEMIC in 41 years. And WE THE PEOPLE OF THE UNITED STATES will have to face this PANDEMIC with the 37th worst quality of healthcare in the developed World.

STAND READY AMERICA TO SEIZE CONTROL OF YOUR NATIONAL HEALTHCARE SYSTEM.

We spend over twice as much of our GDP on healthcare as any other country in the World. And Individual American spend about ten times as much out of pocket on healthcare as any other people in the World. All because of GREED! And the PRIVATE FOR PROFIT healthcare system in America.

And while all this is going on, some members of congress seem mostly concern about how to protect the corporate PROFITS! of our GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE. A PRIVATE FOR PROFIT DISGRACE that is in fact, totally valueless to the public health. And a detriment to national security, public safety, and the public health.

Progressive democrats and others should stand firm in their demand for a robust public option for all Americans, with all of the minimum requirements progressive democrats demanded. If congress can not pass a robust public option with at least 51 votes and all robust minimum requirements, congress should immediately move to scrap healthcare reform and demand that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans under the provisions of HR676 (A Single-payer National Healthcare Plan For All).

Coverage can begin immediately through our current medicare system. With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry. Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan. This is what the vast majority of the American people want. And this is what all objective experts unanimously agree would be the best, and most cost effective for the American people and our economy.

In Mexico on average people who received medical care for A-H1N1 (Swine Flu) with in 3 days survived. People who did not receive medical care until 7 days or more died. This has been the same results in the US. But 50 million Americans don’t even have any healthcare coverage. And at least 200 million of you with insurance could not get in to see your private insurance plans doctors in 2 or 3 days, even if your life depended on it. WHICH IT DOES!

ok, three scrivner disruptions. I've reported him. I hope you all will do the same. This is just getting out of hand.

Posted by: DDAWD

==

It won't do any good. The abuse reports from here go to an email alias that ưsually bounces, I'm sure nobody is monitoring it.

The way to handle scrivener, zouk, and jaked is just to ignore them. As you read from the bottom up, when one of those names scrolls into view, just keep scrolling till the next "Posted by." Go placidly amid the noise an' haste. We have all the information we need to exercise effective time- and aggravation-management.

"Obambi is still trying to figure out what to say about his spineless resolve overseas. three days and still counting. don't expect any actual consequences for Korea. and while Iran is burning, Obambi is fiddling."

It's interesting how unpoliticized the Iran issue has become. I've seen quite a few of the normally antagonistic pundits side with the President over this.

Obambi is still trying to figure out what to say about his spineless resolve overseas. three days and still counting. don't expect any actual consequences for Korea. and while Iran is burning, Obambi is fiddling.

On the home front, another day, another couple trillion is waste.

Even bill Maher, that commie, has figured out that mr stuffed shirt is only good at reading teleprompters, nothing else.

"The Federal Government already runs an extensive health insurance program. All Federal employees are covered (and at reasonable cost to the employee and the employer)through programs negotiated with private insurance companies across this country."

Yeah, when I was working for the Army, my health insurance was easily the best of any job I've had.

The good ol' New Yorker just ran a very interesting article about one of Obama's favorite issues -- more medical dollars spent does not eqaul better health care. All roads seem to lead to doctors, hospitals and other interested parties larding their bills. Hey! Those are the same groups that are trying to sandbag reform!http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

The Federal Government already runs an extensive health insurance program. All Federal employees are covered (and at reasonable cost to the employee and the employer)through programs negotiated with private insurance companies across this country.
I'm very satisfied with my insurance: I have never felt rationed and the whole family has been seeing the same doctors we saw before I was a federal employee. I can choose from a wide variety of HMO/POS and high deductible programs, and even vision and dental programs. The costs are laid out for me, as well as what each program offers, and I pick the program that suits my family best.
If it works for me, why can't it work for my self-employed neighbor, currently being killed by insurance companies that he cannot negotiate with because he has no power in the relationship.

The better coverage is this: why should six senators control the outcome of health care? Just like the stimulus package, why should we allow a senator from Maine and a senator from Utah and a senator from Pennsylvania to control the outcome of the health care reform that we citizens are demanding? To pass an issue like health care, do we really need 60 senators who share the identical view on that single issue? This is nuts.

The public has spoken. In 2006, they overwhelmingly defeated the GOP in elections on the promise that we would discontinue the Iraq War. It's going to last until at least 2011. In 2008, the public overwhelmingly defeated the GOP and, again, it was premised on certain issues like health care reform. And, again, we're allowing six or so Senators -- mostly from smaller states -- to control the outcome of the debate.

Harry needs to seriously examine the nuclear option for legislation. There is just no way anything will get done if you need sixty senators. The filibuster's time has passed.

Andy -- No doctor has to take Medicare. Completely up to them. The reason some doctors oppose certain aspects of Obama's plan is that they, like ex-republican senator bill frist, own profitable private hospital corporatios and they don't want to see their fat margins cut. Some people are getting very rich off our broken system, includng insurance executives.

WHAT GOOD IS NATIONAL HEALTH CARE WHEN A FEDERALLY-ENABLED EXTRAJUDICIAL TARGETING AND PUNISHMENT NETWORK DESTROYS LIVELIHOODS AND DEGRADES THE HEALTH OF UNJUSTLY 'TARGETED' AMERICAN CITIZENS AND THEIR FAMILIES?

WHEN WILL TEAM OBAMA REALIZE THAT A NATIONWIDE, PARALLEL SYSTEM OF VIGILANTE INJUSTICE IS MAKING A MOCKERY OF THE RULE OF LAW IN AMERICA?

Federal citizen volunteer programs fund the "community gang stalkers" who are terrorizing their neighbors as police look the other way -- destroying their livelihoods as their health is degraded by widely-deployed microwave radiation ("directed energy") weapons.

A parallel array of federal "programs of personal financial destruction" slowly decimate the family finances of "target" families -- surely a factor in the mortgage meltdown that precipitated the global financial crisis.

When victims complain, they are told there is "nothing to investigate."

True -- because federal and local authorities KNOW ALL ABOUT IT.

Will the national press corps -- and Team Obama -- wake up and realize that democracy and middle-class wealth are being stolen at the GRASSROOTS?

It is so sad that politicians continue to play their games with such an important issue.
The health care system is broken and we cannot expect or believe that the AMA, insurance companies, drug companies, hospitals will take any steps to fix it as they have benefited far too long to want change. They have benefited greatly from their free rein and you see what it has done to our health care. We pay more for health care than any nation and rank low in quality and performance.
We cannot allow the politicians, big business and the lobbyists continue to rape us. We cannot allow them to turn this plan into another perk for big business.

The reason the AMA is against medicare has nothing to do with the fact that it isn't run decently well, it is that Medicare forces doctors to accept what they pay, which is usually below market value. And as far as I know you have to accept Medicare if you are a physician or hospital.

>> Maybe more if they can attach some medical malpractice reform on it too.

It'd probably have to be fairly major reform but not like I wouldn't welcome it entirely. It's needed it for a long time and would actually do the medical industry and consumers a lot of good.

>>Ask Medicare CUSTOMER/BENEFICIARIES if the government is any good at running a healthcare system!

Actually it's not that bad. It's got flaws, mainly from how restrictive it is in terms of inclusion but I hear very little complaints from people that have it, except from part D.

It definately can be done better, so I honestly don't doubt they could run at least a decent bare bones insurance option. There's no guarentee of drug coverage but there would be options for people needing basic medical care. Couple that with what the private sector has done with medication costs lately would be a good system.

I doubt we'd get the subsidized medicine costs we have in other nations with national healthcare systems. But the drug manufacturers would never go for that here anyway.

Republican Senators grouse that the government is an unfair competitor; the AMA gripes that the government isn't very good at running a healthcare system. Even if one can reconcile the stupidity of these disparate arguments (i.e. most competitors would love to compete against an incompetent rival), everyone recognizes this kind of sniping as the self-serving, special-interest bull that it is. Ask Medicare CUSTOMER/BENEFICIARIES if the government is any good at running a healthcare system! Ask Medicare beneficiaries if they think congressional Republicans ought to allow Medicare to negotiate Drug Prices with Drug Companies--just like their private Insurance Industry competitors can do! Ask me if I liked the "choice" offered to me by my PRIVATE employee-sponsored insurer, of paying 300% more in premiums, for 300% less in benefits over the last 4 years; vs. the other "choice" of going uninsured--for "free." All Private Insurers offer is a host of "bad, badder, or badest" CHOICES!

President Obama is right! WE MUST HAVE A GOVERNMENT-CHOICE OPTION, in order to force the private-sector Cabals of Insurers and Providers to compete in the best interest of their Customers!

Snowe will sign on to a compromise and when Franken gets certified by Pawlenty in about a month the Dems will have their 60 votes. Once the writing is on the wall you will see some more GOPers in moderate states (although that is becoming an endangered species of late) sign on as well. My prediction is that it passes with 62 votes in the senate. Maybe more if they can attach some medical malpractice reform on it too.

Chris - I thought that only 51 votes are necessary for the health care plan. (the budget resolution Congress passed allows the democrats to use the reconciliation process for health care which is not subject to a fillibuster.)

Obama may want to have bipartisan support (or at least Snowe or Collins) but the reality is he can pass it as long as he has 51 democrats on board.